Pressure wound Decubitus treated with Negative pressure wound therapy
The wound has a person under it
When you work with wounds on a daily basis you thank God for small mercies.
You go through life with your ups and downs, feeling good , feeling bad but are you ever ready to face the pain and humiliation that wounds like this can bring?
Decubitus better known as bedsores can be small or as huge as your fist but whatever size they are painful and very often smell terrible. I don't have enough fingers to count how many times i have heard a patient saying they would rather die than go through this. Living with these wounds can be a real challenge for both the patient and their family.
Many decubitus patients are either in wheelchairs or confined to bed and these wounds can appear for many different reasons. Mostly because the patient has been lying on the one spot without being turned often enough. Pressure wounds often start deep next to a boney part of the body. By the time you notice it or the patient is screaming out in pain it is too late, the tissue has been broken down and a wound is in the making.
Pressure sores can appear anywhere but most often they are in the seating area better known as a decuitus wound.
If you are treating a wound like this or someone in your family has one please remember that they can be treated but it will take time. Please also remember that this person is experiencing pain like you could never imagine which will cause them to be miserable. Just going to the bathroom is an ordeal. Not to mention the need for cleaning the wound after each visit. E coli is a threat to any wound.
This person needs your love more now than ever before. Try to understand their anger or lack of enthusiasm and please try to get them the help they so desperately deserve and need.
Finally i would like to mention that without protein zinc and vitamins in the diet wounds are very hard to heal. Many sufferes are already thin but you need to encourage them to have a proper balanced diet if they are to fight the battle of healing a large wound.
Wounds which do not heal are open to all sorts of infections and this must never be taken lightly as it can lead to sepsis which is a life threatening condition.
I have posted some really horrid photos but this is a true life patient and a wound type that i see just too often.
We are all getting older which means that one day that could be us lying there. Honestly most sufferers never ever thought that this could happen to them.
If more people are aware of this then we can at least save a few through prevention instead of curing.
It is all too easy to say that patients developed a pressure wound while lying in hospital, and while in some cases this might be true, many have developed these even before they were admitted.
The hard fact is that once a wound has appeared we know that the patient has been lying hard on the one spot for more than two hours without relief.
You can help to avoid these wounds by turning your patient ever 90 minutes. If the patient has fever you have to make sure that they have extra help to keep skin away from skin. For example one leg lying on top of the other. The heat will cause the skin to stick together and this can cause blisters. Just simply put a pillow between the legs for comfort and this is also enough to keep the skin apart.
Stroke patients are very susceptible to both blistering and decubitus. Don't be frightened to ask the carer how often they turn the patient it might even be a good idea to have a chart put next to the bed. This is a simple tactic and saves many.
The patient in the photos developed a pressure wound through sitting in a wheelchair without any cushioning. She was taking strong painkillers after a road accident and was unable to shift her weight. By the time i was asked to attend to her the wound was already badly infected and necrosis was in the wound. This had to be removed.
We then proceeded to treat daily with negative pressure wound therapy using silver in the treatment gauze. This was a long slow progress but after 3 months we can see that the wound healed entirely. The patient did not need a skin graft and is walking once again. She does need a stabilizer to walk but this exercise each day will keep her circulation healthy and reduce the chance of getting any new wounds.
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